Tools developed to battle HIV infection in vulnerable populations such as intravenous drugs users should be focused on battling hepatitis C infection, according to the author of a study of street youth in Vancouver.

“We were shocked at how prevalent hepatitis C is in this population and really alarmed at the rates of transmission,” said lead author Scott Hadland, a pediatrician and researcher with the British Columbia Center for Excellence.

Researchers recruited 940 street youth, ages 14 to 25, to determine how many would be infected by hep C over time and found that 10 per cent of the participants were already infected. Over the six years of the study, another 11 per cent of participants available for retesting became infected.

Hadland’s findings suggest that earlier estimates of hep C infection among street youth wildly undershot the mark, at least in B.C. A 2012 surveillance report by the Public Health Agency of Canada put infection among street youth in Canada at five per cent.

Deaths attributed to hep C are more common here than deaths due to HIV and, like HIV, intravenous drug use is the biggest risk factor for hep C, said Hadland, who grew up and continues to do research in Metro Vancouver.

Hepatitis C is an infectious disease of the liver that, left untreated, can lead to cirrhosis and death. An estimated 0.8 per cent of all British Columbians have hepatitis C, though a large number of those do not have symptoms and are unaware they are infected. Hep C is spread through contact with infected blood, particularly through sharing needles. Other risky behaviours include unprotected, and body piercings and tattooing.

“A lot of the behaviours that put people at risk for hepatitis C acquisition in youth are similar to those for HIV,” he said. “But we find a much lower rate of HIV infection among street youth, probably owing to the really strong prevention, treatment and harm reduction efforts focused on HIV.”

HIV testing that is routine when members of vulnerable populations come in contact with the health care system should be extended to include testing for hep C and specifically targeted to street youth who are less likely to use adult health outreach services, Hadland said.

Location of the services is also important as street youth tend to avoid adult homeless and addicts, and the programs that serve them, he said.

“It really time we took a second look at how we deliver these services to youth and whether we can apply what we know works for adult drug users,” said Hadland.

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